Hip Bursitis (cont.)
How is hip bursitis diagnosed?
Hip bursitis is diagnosed based on the history of outer hip
pain, specific areas of tenderness of the outside of the hip, and
confirmed by relief with local injection of anesthetic in
the doctor's office. Patients frequently notice pain in the outer hip with stair
climbing or descending and tenderness of the hip when lying on the affected side
at night. The doctor can localize the
tender areas to the location of the bursae of the hip. Occasionally,
X-ray tests of the hip are used to rule out other conditions of the
bone and joints, such as arthritis. Sometimes, but not always,
X-rays can highlight areas of calcium deposits in an inflamed bursa.
How is hip bursitis treated?
The
treatment of any bursitis depends on whether or not it involves infection. Noninfectious or aseptic hip bursitis can be treated with ice
compresses, rest,
and antiinflammatory and pain medications. Occasionally, it
requires
aspiration of the bursa fluid. This
procedure involves removal of the fluid with a needle and syringe under sterile
conditions. It can be performed in the doctor's office. Sometimes the fluid is
sent to the laboratory for further analysis. Frequently, there is inadequate fluid accumulation for aspiration. Noninfectious hip bursitis can
be
treated with an injection of cortisone medication, often with
an anesthetic, into the
swollen bursa.
This is sometimes done at the same time as the aspiration
procedure.
Patients
with hip bursitis can often benefit by weight reduction, stretching exercises,
and wearing proper footwear for exercise activities. Sometimes physical-therapy programs can be helpful.
Generally, patients should avoid hills and stairs and direct
pressure on the affected hip (sleep on the other side), when
possible, while
symptoms are present.
Septic bursitis (again, uncommon in
the hip) requires even further evaluation by a doctor. This is unusual in the
hip bursa but does occur. The bursal fluid can be examined in the laboratory
for the microbes causing the infection. Septic bursitis requires antibiotic
therapy, often intravenously. Repeated aspiration of the infected fluid may be required. Surgical drainage and
removal of the
infected bursa sac (bursectomy) may also be necessary.
- A bursa is a fluid-filled sac that functions as a gliding
surface to
reduce friction between moving tissues of the body.
- There are two major bursae of the hip.
- Bursitis is usually not infectious, but the bursa can become
infected.
- Treatment of noninfectious bursitis includes rest, ice,
and medications for inflammation and pain. Infectious bursitis (uncommon) is
treated with antibiotics, aspiration, and surgery.
- Bursitis of the hip is the most common cause of hip pain.
Last Editorial Review: 9/5/2008
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